TCM -Tx/gifts for referals

[Guest guest]

does anyone know what office of govt reg this, how/where to get legal

clarification? many practitioners give tx for referals. i'm sure the laws

vary state to state. i've had difficulty in NC getting issues like this

pinned down.

 

kb

 

 

On 1/25/07, < wrote:

>

> I was told in practice management class that we can certainly give

> " thank you " cards or even gifts for referrals, but what we cannot do is give

> patients free treatments for their referrals. That is considered " buying

> patients " and is illegal.

>

>

>

> anne.crowley <anne.crowley%40comcast.net> wrote:

> Liz: I am not familar with the joint commission on patient gifts, however,

> I was told that any gifts or fees for referral is a no no. I have to

> sometimes tell patients this, since I might get a hint about that. One time

> a screwed up a patient's appointment, two in the waiting room at the same

> time and only one room. The next time she came in I gave her a bottle of

> herbs free. I think that is fine- also the gifts thing - check what Lynn

> says there about amounts.

>

> Anne

>

> remember, in the states, joint commission places limits on gifts to pts. i

> figure it's good to keep those in

> > mind even if we're not bound by them - unless we're working in a

> hospital or

> > credentialed clinic setting. i'm about to do an ethics review, in '06,

> it was

> > ~$15/gift/pt, $50/cumulative. i like the lifetime library membership

> idea,

> > also. lynn

> >

>

> > [lizzzrd <lizzzrd%40optonline.net>] wrote:

> > The only advertising I pay for is a small listing in the phone book

> under

> > " acupuncture " so that people can find me. More than 2/3 of my clients

> come in

> > because a current or previous patient has referred me. The next largest

> > percentage have been referred by practitioners of various modalities.

> It's

> > been my experience that most people who are new to acupuncture have a

> certain

> > amount of nervousness about it. They much prefer to see an acupuncturist

>

> > recommended by someone they trust.

> >

> > I'd rather put my advertising money into things that support and thank

> my

> > existing patients. To that end, I have a free lending library of books,

> CDs and

> > DVDs on health practices and issues, that I add to on a regular basis.

> Anyone

> > who has ever seen me, even if it's only once, becomes a lifetime member

> of the

> > library. I keep a stock of books on hand - including titles by Roger

> Jahnke,

> > Ellison Haas, Andrew Weil and others - and I always send one as a thank

> you when

> > a referral is made. Whenever a patient inquires whether acupuncture

> might help

> > their friend or family member, I answer their questions and then give

> them a

> > copy of " The Acupuncture Answer Book " to give to the person they're

> concerned

> > about. I occasionally have give-aways in the office for patients -

> little hand

> > massagers, great pens with my name and phone number on them, small jars

> of

> > specialty bath salts for relaxing or for muscle aches. I always send

> personal

> > birthday and anniversary cards out, too.

> >

> > I started doing all these things because I'm a friendly person and

> because I

> > really like and appreciate my patients. Over time, I've come to realize

> that

> > they're much better as marketing tools than any ad I could devise. I've

> never

> > done any internet advertising and probably never will.

> > Peace, Liz Casey

> >

> > -

> > Angela Pfaffenberger

> > To:

Chinese Medicine <Chinese Medicine%40yaho\

ogroups.com>

> > Wednesday, January 24, 2007 4:10 PM

> > Internet advertising

> >

> >

> > There seem to be lots of internet advertising opportunities now-a-days,

> such

> > as listings on a site, such as acufinder.

> >

> > I wondered if people would be willing to share what has worked for them

> - or

> > not worked.

> > I tried google adwords. It was hard to track if it brought in clients

> but it's

> > afterall very inexpensive once you actually have a website.

> > Angela Pf

> >

> >

[Guest guest]

Hi Kath

 

The relevant info is contained within the Stark law which regulates

medical kickbacks and ethics. I am not an expert in it, but I think

the complete prevention of gifts to patients is pretty draconian. I

know coupons are OK, so where is the line? But I will ask my cousin, a

lawyer who is an expert in medical and acupuncture law and

specifically Stark law, when I see him tonight. As I understand it,

Stark prevents any sort of gift or payment for referrals between

professionals or entities that could mutually enrich each other while

potentially giving the pateen of not giving appropriate care. My

interpretation, which means nothing, is that it wouldn't apply to

patients.

 

I will report back...

 

Greg

 

P.S. Just a friendly reminder for everyone: please trim the messages

when replying so we don't have to scroll through pages of the same

past posts. Thanks.

 

***********************************************************************

***

Dr. Greg Sperber, BMBS, DAOM, MBA, L.Ac.

California Licensed Acupuncturist

Diplomate in Oriental Medicine (NCCAOM)

Greg

***********************************************************************

****

 

 

Chinese Medicine , " Kath Bartlett,

MS, LAc " wrote:

>

> does anyone know what office of govt reg this, how/where to get legal

> clarification? many practitioners give tx for referals. i'm sure

the laws

> vary state to state. i've had difficulty in NC getting issues like

this

> pinned down.

>

> kb

[Guest guest]

thanks for researching this. is the stark law fed or CA state?

 

i'm having trouble altering/deleting text in replies to the TCM group with

my google email, sorry for the inconvience. will try to figure it out.

 

kb

 

 

On 1/26/07, sperb1 <greg wrote:

>

> Hi Kath

>

> The relevant info is contained within the Stark law which regulates

> medical kickbacks and ethics. I am not an expert in it, but I think

> the complete prevention of gifts to patients is pretty draconian. I

> know coupons are OK, so where is the line? But I will ask my cousin, a

> lawyer who is an expert in medical and acupuncture law and

> specifically Stark law, when I see him tonight. As I understand it,

> Stark prevents any sort of gift or payment for referrals between

> professionals or entities that could mutually enrich each other while

> potentially giving the pateen of not giving appropriate care. My

> interpretation, which means nothing, is that it wouldn't apply to

> patients.

>

> I will report back...

>

> Greg

>

> P.S. Just a friendly reminder for everyone: please trim the messages

> when replying so we don't have to scroll through pages of the same

> past posts. Thanks.

>

> ***********************************************************************

> ***

> Dr. Greg Sperber, BMBS, DAOM, MBA, L.Ac.

> California Licensed Acupuncturist

> Diplomate in Oriental Medicine (NCCAOM)

> Greg <Greg%40SperbsHerbs.com>

> ***********************************************************************

> ****

>

> --- In

Chinese Medicine <Chinese Medicine%40yaho\

ogroups.com>,

> " Kath Bartlett,

> MS, LAc " wrote:

> >

> > does anyone know what office of govt reg this, how/where to get legal

> > clarification? many practitioners give tx for referals. i'm sure

> the laws

> > vary state to state. i've had difficulty in NC getting issues like

> this

> > pinned down.

> >

> > kb

>

>

>

 

 

 

--

Kath Bartlett, LAc, MS, BA UCLA

Oriental Medicine

Experienced, Dedicated, Effective

 

Asheville Center For

70 Woodfin Place, Suite West Wing Two

Asheville, NC 28801 828.258.2777

kbartlett

www.AcupunctureAsheville.com

 

 

 

[Guest guest]

Actually my understanding is that you cannot offer or give a kick back to

another provider, if it is case by case or patient per patient, sort of thing.

But you can give an " unrelated gift " . When I worked in an office with a number

of physicians, a lot of stuff showed up on Christmas, usually bottles of wine,

but also Starbucks stuff, restaurant gift certificates, etc. And of course you

can refer back, very powerful stuff. I noticed that the physician referred to a

specific colleague, but did not see that person when he needed care himself. I

think providers refer to people they like and those that support their

practices. I also noticed that a significant number of referral decisions are

made by the staff, nurses, secretaries, etc; bringing donuts if you visit for a

presentations is definitely worth it; just my 2 cents. Angela Pf

 

 

..

-

sperb1

Chinese Medicine

Friday, January 26, 2007 5:37 AM

Re: TCM -Tx/gifts for referals

 

 

Hi Kath

 

The relevant info is contained within the Stark law which regulates

medical kickbacks and ethics. I am not an expert in it, but I think

the complete prevention of gifts to patients is pretty draconian. I

know coupons are OK, so where is the line? But I will ask my cousin, a

lawyer who is an expert in medical and acupuncture law and

specifically Stark law, when I see him tonight. As I understand it,

Stark prevents any sort of gift or payment for referrals between

professionals or entities that could mutually enrich each other while

potentially giving the pateen of not giving appropriate care. My

interpretation, which means nothing, is that it wouldn't apply to

patients.

 

I will report back...

 

Greg

 

P.S. Just a friendly reminder for everyone: please trim the messages

when replying so we don't have to scroll through pages of the same

past posts. Thanks.

 

***********************************************************************

***

Dr. Greg Sperber, BMBS, DAOM, MBA, L.Ac.

California Licensed Acupuncturist

Diplomate in Oriental Medicine (NCCAOM)

Greg

***********************************************************************

****

 

Chinese Medicine , " Kath Bartlett,

MS, LAc " wrote:

>

> does anyone know what office of govt reg this, how/where to get legal

> clarification? many practitioners give tx for referals. i'm sure

the laws

> vary state to state. i've had difficulty in NC getting issues like

this

> pinned down.

>

> kb

 

 

 

 

 

 

[Guest guest]

Hi Kath

 

As a follow-up, I did see my cousin, the lawyer. What I didn't know

at the time I wrote the original email was that there would be

another four lawyers, all experts in Stark law at this dinner party.

And there was a good discusion. So as far as I am concerned the info

here is absolutely definitive.

 

The Stark law is federal legislation designed to keep Medicare costs

low. It clearly state that gifts to other professionals for

referrals is illegal. As stated by another post, unrelated gifts

(random gifts not connected with referrals) are always unregulated

and legal. Stark law does not say anything about gifts to patients

for referrals. That would appear to be legal.

 

However, and you knew that was coming, California takes the Stark

law and one ups it. It IS illegal to give gifts to patients in

exchange for referrals in the state of California. The relevant

California law is:

 

California Business & Professions Code Section 650:

 

" (a) Except as provided in Chapter 2.3 (commencing with Section

1400) of Division 2 of the Health and Safety Code, the offer,

delivery, receipt, or acceptance by any person licensed under this

division or the Chiropractic Initiative Act of any rebate, refund,

commission, preference, patronage dividend, discount, or other

consideration, whether in the form of money or otherwise, as

compensation or inducement for referring patients, clients, or

customers to any person, irrespective of any membership, proprietary

interest or coownership in or with any person to whom these

patients, clients, or customers are referred is unlawful.

 

* * *

 

(g) A violation of this section is a public offense and is

punishable upon a first conviction by imprisonment in the county

jail for not more than one year, or by imprisonment in the state

prison, or by a fine not exceeding fifty thousand dollars ($50,000),

or by both that imprisonment and fine. A second or subsequent

conviction is punishable by imprisonment in the state prison or by

imprisonment in the state prison and a fine of fifty thousand

dollars ($50,000). "

 

You can see from this that the receiver of the gift is irrelevant;

the law is about who gives the gift. And we can also see the maximum

penalties, which are not minimal. Thanks to Charles Witham, JD for

the reference.

 

So the bottom line: Stark law prohibits gifts for referrals among

professionals. But it appears to be a state by state issue as far as

gifting to patients for referrals with California banning it.

 

I hope this helps. And I concur with Angela: the best way to a

doctor or his staff is through their stomachs.

 

Greg

 

*********************************************************************

*****

Dr. Greg Sperber, BMBS, DAOM, MBA, L.Ac.

California Licensed Acupuncturist

Diplomate in Oriental Medicine (NCCAOM)

Greg

*********************************************************************

******

 

 

Chinese Medicine , " Kath Bartlett,

MS, LAc " wrote:

>

> thanks for researching this. is the stark law fed or CA state?

>

> i'm having trouble altering/deleting text in replies to the TCM

group with

> my google email, sorry for the inconvience. will try to figure it

out.

>

> kb

>

>

> On 1/26/07, sperb1 <greg wrote:

> >

> > Hi Kath

> >

> > The relevant info is contained within the Stark law which

regulates

> > medical kickbacks and ethics. I am not an expert in it, but I

think

> > the complete prevention of gifts to patients is pretty

draconian. I

> > know coupons are OK, so where is the line? But I will ask my

cousin, a

> > lawyer who is an expert in medical and acupuncture law and

> > specifically Stark law, when I see him tonight. As I understand

it,

> > Stark prevents any sort of gift or payment for referrals between

> > professionals or entities that could mutually enrich each other

while

> > potentially giving the pateen of not giving appropriate care. My

> > interpretation, which means nothing, is that it wouldn't apply to

> > patients.

> >

> > I will report back...

> >

> > Greg

> >

> > P.S. Just a friendly reminder for everyone: please trim the

messages

> > when replying so we don't have to scroll through pages of the

same

> > past posts. Thanks.

> >

> >

*********************************************************************

**

> > ***

> > Dr. Greg Sperber, BMBS, DAOM, MBA, L.Ac.

> > California Licensed Acupuncturist

> > Diplomate in Oriental Medicine (NCCAOM)

> > Greg <Greg%40SperbsHerbs.com>

> >

*********************************************************************

**